Sarcopenic Obesity in Metabolic and Bariatric Surgery: A Scoping Review
Flávio Teixeira Vieira, Carla M. Prado, Jessica Thorlakson, Carlene Johnson Stoklossa, Jennifer Jin, Lorenzo M. Donini, Leah Gramlich, Barbara Bielawska
Abstract
The risk of sarcopenic obesity (SO), characterized by the coexistence of excess adiposity and low muscle mass and function, may be increased in metabolic and bariatric surgery (MBS). There is a possibility of SO development after surgery, but also aggravation of pre-existing SO, a hidden condition associated with poor health-related outcomes. This scoping review synthesizes existing literature on SO in MBS, with a thorough discussion of diagnostic criteria and assessment methods, investigation of SO prevalence (presurgery and postsurgery), incidence postsurgery, and impact on clinical outcomes. SO prevalence in MBS is highly heterogeneous, depending on the applied diagnostic criteria and body composition/physical function assessments. Following appropriate diagnostic criteria, one of four individuals both before and post-MBS seems to have SO, thus requiring targeted interventions. SO may be associated with lower weight loss and quality of life, increased risk of gastric leak, prolonged operation time, and hospital stay. Increased awareness of postsurgery SO is recommended, especially with aging. Standardization of SO diagnosis is urgently needed to improve identification and enable comparisons among studies and associations with clinical outcomes. This is important for developing effective policies, guidelines, and interventions to better address and manage this condition.